Associate Chief of Nursing Service for Research, SFVAMC
Associate Clinical Professor of Nursing, UCSF
Email: martha.buffum@va.gov

Patients' fear and anxiety prior to gastrointestinal exams (e.g. colonoscopy) and vascular angiography (e.g. angiograms) pose considerable nursing care challenges: reducing patients' discomfort, feelings of vulnerability and embarrassment, and fear about possible findings. Another result might be more difficult and painful procedures with greater need for sedating medication. Dr. Buffum and colleagues have effectively reduced veterans' anxiety prior to GI procedures using music that veterans select.  As a result of this study, the SFVAMC GI Diagnostic Center provides music to all patients undergoing procedures. Dr. Buffum and colleagues are currently conducting a similar study in vascular angiography to reduce patients' anxiety prior to these procedures.

Dr. Buffum also studies pain in older adults with dementia, which is often overlooked because cognitive and communication deficits interfere with these patients' ability to verbalize their physical discomfort. Dr. Buffum and colleagues have tested methods for determining how patients with dementia demonstrate pain, and potential methods for relieving that pain. Further studies include determining nurses' pain evaluation methods for patients with dementia in all areas of the hospital, and learning family caregivers' descriptions of pain management of their loved ones when transferred from home to nursing homes and hospital settings. These innovative studies are unique in the VA and show that persons with dementia should be evaluated for individual expression and treatment of pain and discomfort in all settings.

Hutt E, Buffum MD, Fink R, Jones KR, Pepper G. 2008. Optimizing pain management in nursing homes. Geriatrics and Aging 10(8):523-527.

Buffum M. 2008. The role of family caregivers in pain management in patients with dementia. J Pain Manage (in press).